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First Name:
Last Name:
Middle Name:
Address:
Home Telephone:
Work Telephone:
Email:
Social Security #:
Referral Source:
If "other":
Position(s) Applied For:

Have you filed an application here before?

Have you ever been employed here before?

Are you on a lay-off and subject to recall?

Have you been convicted of a felony or misdemeanor within the last five years?
(Conviction may not necessarily disqualify you for the job applied for):

If yes, state offense(s), date, place, and disposition. In answering these questions you may omit any information or answer "no record" with regard to any conviction for which there is a sealed record on file with the commissioner of Probation. You may also omit first convictions for drunkenness, simple assault, speeding, minor traffic violations, affray or disturbance of the peace.

Do you have an unrestricted right to work in the United States? If hired, you will be required to show proof of eligibility to work for the Boston Rescue Mission in the capacity for which you have applied:

If you are applying for a clerical position, complete the following by indicating degree of experience and/or skill as specified in each area. As part of the interview process, you may be required to be tested in position related skill areas.

Secretary:
Filing:
Accounting:
Receptionist:
Typing (wpm):
Computer Data Entry:
Shorthand speed (wpm):
Word-processing Speed :

Please specify computer, technology or office-related skills that you are proficient in, and duration/level of experience for each. Examples include: Microsoft Word, Excel, Adobe Photoshop, Internet-related skills, computer networking skills, etc.:
Please summarize skills any other qualifications acquired from employment, military service or other experience:
If you are applying for a bilingual position, list languages, other than English, that you can read, write and speak fluently:

Employment Experience: Starting with your present of last job, list your past three employers:
Employer:
Telephone #:
Address:
Dates Employed:
Job Title:
Supervisor:
Title:
Beginning Hourly Rate/Salary:
Ending Hourly Rate/Salary:
Reason For Leaving:

Employer:
Telephone #:
Address:
Dates Employed:
Job Title:
Supervisor:
Title:
Beginning Hourly Rate/Salary:
Ending Hourly Rate/Salary:
Reason For Leaving:

Employer:
Telephone #:
Address:
Dates Employed:
Job Title:
Supervisor:
Title:
Beginning Hourly Rate/Salary:
Ending Hourly Rate/Salary:
Reason For Leaving:

Education

	High School	College/University	Graduate/Professional
School Name and Address
Years Completed
Diploma/Degree Specify Degree
Course of Study/Specialization
Specialized Training, Intern/apprenticeships, honors, activities, etc.


Personal References
List those familiar with your capabilities, including the supervisors noted under "Employment Experience," (Please do not list relatives.)

Name:
Relationship:
Address:
Telephone:

Name:
Relationship:
Address:
Telephone:

Name:
Relationship:
Address:
Telephone:

May we contact your present employer/supervisor?
Please answer the following questions, using a separate sheet of paper if necessary:
Why does service to the urban poor interest you?
Why does a position at the Boston Rescue Mission interest you?
Have you had any work, volunteer, or service experience with the urban poor? If yes, please circle one, and provide the name of the establishment with which your were associated.
If you have answered "yes" to #3, please tell us, what new insights, understanding or experience have you gained as a result of your experience?
What special gifts or qualifications do you have to contribute to the Boston Rescue Mission?
What are your career and/or life goals?
How would service at Boston Rescue Mission help to prepare you to realize your career goals/and or life goals?
What do you hope or expect to learn as a result of your experience at Boston Rescue Mission?
Do you consider yourself a team player? Why or why not?
Is there anything else that you would like to tell us about yourself?
Thank you for applying for service at the Boston Rescue Mission! Liability Release:
By clicking the "Submit" button below I hereby certify that the information contained in this application, or in any attachments to it (including resumes) is true to the best of my knowledge and agree to have any of the statements checked by the Boston Rescue Mission unless I have indicated to the contrary. I authorize the references listed above to provide the Boston Rescue Mission any and all information concerning my previous employment and any pertinent information that they may have. Further, I release all parties from all liability for any damage that may result from use of such information by the Boston Rescue Mission. I understand that any misrepresentation, falsification or material omission of information may result in my failure to receive an offer, or if I am hired, in my dismissal from employment. In consideration of my employment at the Mission, I agree to conform to the rules and standards of the organization and agree that my employment is considered as employee-at-will, and as a result, my compensations can be terminated at-will, with or without cause, and with or without notice at anytime, either at my option or at the option of the organization. I understand that no employee or representative of the organization other than the President of the Mission has the authority to enter into any agreement for service for any specified period of time or to make any agreement contrary to the foregoing. Further, the President may not alter the at-will nature of the service relationship unless (he/she) does so specifically and in writing. I also understand that all offers of employment are conditioned on the provision of satisfactory proof of an applicant's identity and legal authority to work in the United States.